208例慢性泪囊炎患者病原菌检出情况及药敏试验结果分析  

Pathogen distribution and drug sensitivity in 208 patients with chronic dacryocystitis

作　　者：沈丽冬 沈惠 金烨 张永杰 杜诚 SHEN Lidong;SHEN Hui;JIN Ye;ZHANG Yongjie;DU Cheng(Department of Ophthalmology,Jiaxing TCM Hospital affiliated to Zhejiang Chinese Medical University,Jiaxing 314001,China;不详)

机构地区：[1]浙江中医药大学附属嘉兴中医院眼科,314001 [2]浙江中医药大学附属嘉兴中医院检验科,314001

出　　处：《浙江医学》2025年第1期64-67,71,共5页Zhejiang Medical Journal

基　　金：嘉兴市科技计划项目(2022AD30111);嘉兴市省市共建医学重点学科建设计划项目(2021XK-省市共建-眼科);浙江中医药大学校级科研项目附属医院科研专项(2024FSYYZY16)。

摘　　要：目的分析208例行鼻内镜下泪囊鼻腔吻合术的慢性泪囊炎患者病原菌检出情况及药敏试验结果,以期为临床合理选择抗菌药物提供参考。方法回顾性选取2022年1月至2024年3月在浙江中医药大学附属嘉兴中医院眼科住院行鼻内镜下泪囊鼻腔吻合术的慢性泪囊炎患者208例。术中切开泪囊,收集脓液标本,将标本接种于增殖培养瓶中,置BACT/ALERT 3D培养仪中进行细菌培养,并参照操作规程对细菌进行分离纯化鉴定及药敏试验。结果208例患者中共81例标本培养阳性,占38.94%,其中细菌培养阳性80例,真菌培养阳性1例。81例阳性标本中共测得菌种95株,革兰阳性球菌占83.16%(79/95),其中表皮葡萄球菌最为常见,占51.58%(49/95);革兰阴性杆菌占15.79%(15/95)。对分离的49株表皮葡萄球菌和15株金黄色葡萄球菌进行药敏试验,显示所有菌株对奎奴普丁/达福普汀、利福平、利奈唑胺、替加环素、呋喃妥因、万古霉素等均有较高的敏感性,耐药率低;对苯唑西林、莫西沙星、环丙沙星、左氧氟沙星、左旋氧氟沙星、青霉素等的敏感性较低,耐药率较高。结论慢性泪囊炎患者病原菌以革兰阳性球菌为主,尤其是表皮葡萄球菌,其病原菌分布及耐药性已较前发生变化。为提高慢性泪囊炎患者临床治疗的有效性,临床应依据药敏试验结果,合理选用抗菌药物进行治疗。Objective Analyze the distribution of pathogenic bacteria and drug sensitivity in 208 patients with chronic dacryocystitis.Methods Clinical data of 208 patients with chronic dacryocystitis who underwent endoscopic dacryocystorhinostomy in the Ophthalmology Department of Jiaxing TCM Hospital from January 2022 to March 2024 were retrospectively analyzed.The pus specimens collected from the dacryocyst during surgery were inoculated in a BACT/ALERT 3D incubator for bacterial culture,and drug sensitivity tests were performed.Results Total 81 specimens showed positive culture results(38.94%),80 were positive for bacterial culture and 1 for fungal culture.Among 81 positive specimens,95 bacterial strains were identified,and 79 were Gram-positive cocci(83.16%).Staphylococcus epidermidis was the most common isolates,accounting for 51.58%(49/95),and Gram-negative bacilli accounted for 15.79%(15/95).Drug sensitivity tests showed that all strains were highly sensitive to quinupristin/dalfopristin,rifampin,linezolid,tigecycline,nitrofurantoin,vancomycin;while the sensitive rate to oxacillin,moxifloxacin,ciprofloxacin,levofloxacin,levofloxacin,penicillin was low.Conclusion The pathogenic bacteria in patients with chronic dacryocystitis are mainly Gram-positive cocci,especially Staphylococcus epidermidis.To improve the effectiveness of treatment it is necessary to reasonably select antibiotics based on drug sensitivity tests.

关 键 词：慢性泪囊炎 泪囊鼻腔吻合术 病原菌 耐药性 回顾性研究 

分 类 号：R446.5[医药卫生—诊断学] R777.23[医药卫生—临床医学]